The diagnostic accuracy of diffusion-weighted magnetic resonance imaging and shear wave elastography in comparison to dynamic contrast-enhanced MRI for diagnosing BIRADS 3 and 4 lesions

Abstract Background Breast cancer is one of the leading causes female morbidity and mortality. Management options vary between lesions BIRADS categories 3 4. Therefore, reliable differentiation would improve outcome. Although sonomammography contrast-enhanced breast magnetic resonance imaging (CE-MRI) remain cornerstone for assessment disease, additional, non-invasive techniques can be used to increase efficiency evaluation such as shear wave elastography (SWE) diffusion-weighted (DW-MRI). This prospective study included 66 that were categorized or 4 by ultrasound ± mammography. All evaluated SWE, CE-MRI DW-MRI. For both qualitative quantitative methods. CE-MRI, morphological kinematic evaluations done DW-MRI, assessments studied. Results all modalities correlated histopathology. Thirty-seven out examined (56.06%) categorised 3, which 1 (2.7%) turned malignant on histopathology 36 (97.29%) proved benign. Twenty-nine (43.93%) 4, 2 (6.89%) benign pathology 27 (93.1%) malignant. Morphological showed 92.59% 92.86%sensitivity, 94.74% 84.21% specificity, 92.59 81.25%PPV, 94.74 94.12% NPV, 93.85% 87.88% accuracy respectively. Color-coded scoring SWE indices 89.29%, 68.42%, 67.57%, 89.66%, 77.27% The calculated cut-off value E max differentiating from was 65.15 kpa, resulting in 96.43%, 57.89%, 95.65%, 62.79%, 74.24% ratio, 4.55, 71.43%, 76.47%, 62.50% 69.70% 78.57%, 65.79%, 62.86%, 80.65%, 71.21% ADC, 1.25 × 10 mm /s, resulted 75.00%, 84.21%, 82.05%, 77.78%, 80.30% Conclusion best diagnostic performance indices. While, DW-MRI present variable performance, an adjunct other aid clinical decision its confidence.